Magical Thinking

After being referred to see an outpatient psychiatrist I had a few weeks to wait before my appointment.  I arrived slightly late, as was usual for me during those days, and waited to be seen.  A small woman came to fetch me, Dr Singhal she was called.  I sat in the chair of this old fashioned doctors room, which was cold and smelled slightly damp.  She asked me endless questions about my childhood, growing up and my current situation.  I remember being irritated by her referral to my self-harm as 'self-laceration'.  She diagnosed me with depression and anxiety, which came as no surprise.  I saw her a around once a week over the following months.  She had changed my medication to Citalopram and I was also taking Diazepam (Valium) for anxiety, and Temazepam (Restoril) to help with sleep.


I'd been seeing her for around six weeks when I took my very first overdose.  I won't go into detail of that at this point, but it was shortly after this she diagnosed me with obsessive-compulsive disorder.  I remember being confused.  I didn't see any of the behaviours I did as obsessive-compulsive.  My impression of OCD was that of checking.  I'd always been a little bit obsessive with hygiene, but I would never have gone as far as to say it was severe enough to warrant a diagnosis of OCD.


She explained to me that a less common symptom of OCD is "magical thinking" and an "inflated responsibility". An excellent run down of OCD symptoms can be found here but I'll just highlight the relevant bits to my diagnosis.

Inflated responsibility and magical thinking

If you have OCD you have an inflated sense of responsibility. This means that you believe you have the power to either cause or prevent bad events that are personally important to you. 'Magical' thinking - performing special actions to prevent something happening (an extreme form of superstitious thinking) - is closely related to this. It makes you feel more comfortable, as if you had more influence and control over what happens.

The over-importance of thoughts

This means the degree of importance that you attach to intrusive thoughts or images. It's crucial to understand here that everyone experiences intrusive thoughts and doubts - that are usually absurd and are the opposite of what they want to do or think. In the 1970s researchers carried out experiments where they asked some people with OCD and some people without OCD to list their intrusive thoughts. They could find no difference in the types of thought reported by those with and those without OCD. The difference is that people with OCD have more frequent and distressing thoughts than others because of the meaning they attach to the thoughts and the way they respond to them. OCD is maintained when you interpret intrusive thoughts as a sign that is there a serious risk of harm to yourself or others (over-importance of thoughts), and also believe that you can prevent the harm by what you do or don't do (overinflated responsibility).
The actual content of intrusive thoughts comes from your values - the things that are most important to you. The thoughts represent your deepest fears. So, for example, a mother might have intrusive thoughts about stabbing her baby, because he is the most precious thing in the world to her and she would be devastated if anything happened to him.


(Full information about symptoms of OCD can be found at www.overcoming.co.uk)

After several weeks of denial I completely understood where she was coming from.  I didn't suffer from the stereotypical forms of OCD such as checking etc, although many of the "traditional" traits were present, but the magical thinking side of things certainly rang true.  


For the last eight months I'd been performing certain behaviours, from something as small as moving an object to a different place, or something slightly more serious like overdosing, to prevent harm from happening to those around me.  At it's worst I felt I HAD to cut myself fifty times a day to protect my friends and family.  Although I'm slightly more in control of things now I do still carry out random protective acts.


I also suffer with very intrusive thoughts about those around me dying.  It feels like by having the thought in my head, the likelihood of the event happening is increased.  That leads to a great deal of anxiety, which in turns leads me back to magical thinking.


My symptoms have been exacerbated further as my mother spent several years in and out of hospital with various illnesses.  At certain points she nearly died.  All of this has fed into the process and sadly made things a lot worse.  Fortunately she's been healthy for a few years now and I think things are settling down.  


When my cleanliness and hygiene symptom gets bad I end up scrubbing at my skin with bleach, or bathing in it to keep clean.  Fortunately I've been able to downgrade from bleach to medicated Dettol of TCP liquid.  


I went on to attend ten sessions of OCD group therapy.  Although I found it slightly helpful, the majority of the group suffered from checking behaviours and my struggle with magical thinking was for the most part misunderstood by the others in the group.  It took me seven weeks to realise how the programme could possibly help me.  Still, I did learn a few valuable coping skills.